Effectiveness of COVID-19 vaccination in Brazil: innovative community engagement approaches

Overview 

The DP-EFFECT project ran from July 2021 to October 2022 as part of the International COVID-19 Data Alliance (ICODA) initiative. The research team used different types of data to look at the effectiveness of COVID-19 vaccines in Brazil in protecting individuals and populations from infection and severe disease. They analysed vaccination rates in adults in 5,500 Brazilian municipalities, finding that socioeconomic disparities impacted on first dose vaccination and disease protection, with primary healthcare proving critical in providing more equitable access to vaccines for vulnerable populations.  

 Having highlighted these disparities, the team carried out a more detailed study in a vulnerable favela community in Rio de Janeiro (Vacina Maré) and took innovative approaches to community engagement that resulted in a  major increase in vaccination rates.   

The challenge 

The DP-EFFECT study ran between July 2021 and October 2022, a short time frame in which the team identified that socioeconomic disparities resulted in vulnerable communities having lower COVID-19 vaccination rates and protection from the disease.  To address this challenge, they worked with communities and other stakeholders in the favelas in Rio de Janeiro to work together to identify health care priorities during the pandemic, develop effective communications and improve access to COVID-19 vaccines. This built trust and understanding, and ensured effective involvement and engagement of the local communities in wider research study design and delivery to improve health outcomes for all.  

The solution 

The research team took a shared leadership approach to involvement and engagement, and the project involved academics, non-governmental organisations, public and private sectors: critically, the team worked with local communities from the outset. This included engagement with vulnerable communities in the favelas in Rio de Janeiro through the Vacina Maré vaccination programme. The team brought together community members to identify healthcare priorities relating to the COVID-19 pandemic, to develop trustworthy approaches to research and health service delivery, and to jointly develop effective communications approaches. They have since developed a toolkit and run workshops for researchers in other countries and regions on community engagement for a wide range of global health research studies. 

The impact 

The study produced important insights that informed local and regional vaccination programmes, and these findings were communicated widely via many channels to a range of stakeholders, particularly to vulnerable communities, at a time when public communication about the pandemic and vaccination approaches was limited.  Findings of the study were communicated via social media, reaching more than 2 million viewers, with over 500 media insertions in local and international news. 

This study not only highlighted differences in protection of individuals and communities from severe disease, relating to inequity and vaccination campaign and had a major impact on vaccination rates in the favela community, but also formed the foundation for subsequent studies relating to Long COVID, the impact of the pandemic on mental health and more generally, studies which focus on addressing health challenges working with vulnerable populations.  

More details of this study can be found on the ICODA website.